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Figure 1. Twelve-lead resting ECG (paper speed 25 mm/s) showing normal sinus rhythm with a short PQ interval, but there is no clear “Delta” wave in any lead

                                                                                                                                  

Figure 2.Twelve-lead ECG taken during supraventricular tachycardia (paper speed 25 mm/s)

Figure 3. Intracardiac recordings taken during the electrophysiology study (paper speed 100 mm/s)

Five surface ECG (I,II,III,AVF, V1,V2)/ HRA in the right ventricle, HIS bundle region (HISd,HISi,HISp)/ Decapolar CS cathether (CS 1-2 is the distal pole)/ MAPd bipolar recording from the mapping catheter, MAPd located in the anterior part of the mitral valve

A. AVNRT

B. Concealed left accessory pathway

C. Right-sided accessory pathway

D. Atrial flutter with 1:1 conduction

 

 

Ayan Abdrakhmanov, Zhandos Esilbayev

Department of Interventional Arrhythmology

National Research Cardiac Surgery Center

Nur-Sultan, Kazakhstan

Peer-review: Internal

Authorship: A.A. and Z.E. equally contrıbuted to preparation of quiz

Conflict of interest: None to declare

         Acknowledgement and funding: None to declare